U.S. patent application number 12/449619 was filed with the patent office on 2010-08-05 for biopsy forceps for taking one or more samples.
This patent application is currently assigned to MULTI BIOPSY SAMPLING CO. ApS. Invention is credited to John Bleibach, Lars Schoning.
Application Number | 20100198106 12/449619 |
Document ID | / |
Family ID | 39446289 |
Filed Date | 2010-08-05 |
United States Patent
Application |
20100198106 |
Kind Code |
A1 |
Bleibach; John ; et
al. |
August 5, 2010 |
BIOPSY FORCEPS FOR TAKING ONE OR MORE SAMPLES
Abstract
The invention relates to biopsy forceps for collecting tissue
samples and the like in connection with the use of some kind of
examination or treatment telescope (1) in the treatment of humans
or animals, wherein the part of the forceps (1) that performs
cutting or shearing is provided with an exchange in the form of two
mutually hinged arms (5, 9), wherein the first arm (5) comprises a
holder device (6, 14) for securing a receptacle part (7, 12), which
receptacle part (7, 12) is, at the end that faces away from the arm
(5) in which the receptacle (7) is secured, provided with a cutting
means (8), and wherein a second arm (9) which, during the sampling,
cooperates with the first arm (5) with the receptacle, is provided
with a kind of stop means or abutment (10) which cooperates with
the cutting means (8) on the receptacle (7, 12) to cut off or shear
off the tissue sample (11). The biopsy forceps (1) is provided with
an exchangeable receptacle (7, 12) for storing one or more tissue
samples (11).
Inventors: |
Bleibach; John; (Hellerup,
DK) ; Schoning; Lars; (Hellerup, DK) |
Correspondence
Address: |
DYKEMA GOSSETT PLLC
FRANKLIN SQUARE, THIRD FLOOR WEST, 1300 I STREET, NW
WASHINGTON
DC
20005
US
|
Assignee: |
MULTI BIOPSY SAMPLING CO.
ApS
|
Family ID: |
39446289 |
Appl. No.: |
12/449619 |
Filed: |
February 18, 2008 |
PCT Filed: |
February 18, 2008 |
PCT NO: |
PCT/DK2008/000071 |
371 Date: |
March 9, 2010 |
Current U.S.
Class: |
600/564 |
Current CPC
Class: |
A61B 2010/0225 20130101;
A61B 10/0266 20130101; A61B 10/0096 20130101; A61B 2017/2931
20130101; A61B 2017/2939 20130101; A61B 10/06 20130101 |
Class at
Publication: |
600/564 |
International
Class: |
A61B 10/06 20060101
A61B010/06 |
Foreign Application Data
Date |
Code |
Application Number |
Feb 19, 2007 |
DK |
PA 2007 00253 |
Claims
1. Biopsy forceps for taking tissue samples and the like in
connection with the use of some kind of examination or treatment
telescope (1) in the treatment of humans or animals, characterised
in that the part of the forceps (1) that performs cutting or
shearing is provided with an exchange in the form of two mutually
hinged arms (5, 9), wherein the first arm (5) comprises a holder
device (6, 14) for securing a receptacle part (7, 12), which
receptacle part (7, 12) is, at the end that faces away from the arm
(5) in which the receptacle (7) is secured, provided with a cutting
means (8); and wherein a second arm (9) which, during the sampling,
cooperates with the first arm (5) with the receptacle (7) is
provided with some kind of stop means or abutment (10) that
cooperates with the cutting means (8) on the receptacle (7, 12) to
cut off or shear off the tissue sample (11).
2. Biopsy forceps according to claim 1, characterised in that the
biopsy forceps (1) are provided with an exchangeable receptacle (7,
12) for storing one or more tissue samples (11).
3. Biopsy forceps according to claim 1, characterised in that the
biopsy forceps (1) is provided with a container (12) for taking
several tissue samples (11), which receptacle (12) comprises a
number of chambers (13) for storing one or more samples (11).
4. Biopsy forceps according to claim 3, characterised in that the
receptacle (12) is configured with a number of chambers (13)
arranged along the circumference of the container and around the
axis of rotation of the receptacle (12).
5. Biopsy forceps according to claims 1-4, characterised in that
the inner surface of the receptacle (7) or the chamber (13) is
provided with one-way protrusions for retaining in the container
(7) or the chamber (13) a collected sample (11).
6. Biopsy forceps according to claims 1-5, characterised in that,
at the end of a cable (2), coupling means (4) are provided for
exchangeably securing a tool (3) for use in connection with the
cable (2).
7. Biopsy forceps according to claims 1-6, characterised in that
the receptacle (7) or the chamber (13) is provided with
perforations at the end that faces away from the cutting means
(8).
8. Biopsy forceps according to claims 1-7, characterised in that
the receptacle (7) or the chamber (13) is provided with a kind of
grating at the end that faces away from the cutting means (8).
9. Biopsy forceps according to claims 3-8, characterised in that
the receptacle (12) is configured as a turnable drum or cylinder
comprising a plurality of chambers (13) for collecting samples
(11).
10. Biopsy forceps according to claim 9, characterised in that the
biopsy forceps (1) are provided with an advancement mechanism (15)
for advancing a chamber to sampling position by turning of the drum
or the cylinder (12).
Description
[0001] The invention relates to biopsy forceps for taking tissue
samples and the like in connection with the use of a kind of
examination or treatment telescope in the treatment of humans or
animals.
PRIOR ART
[0002] In recent years it has become increasingly common to perform
examinations and/or surgical interventions by means of a kind of
telescope. The advantage of using an examination and/or treatment
telescope is that it is necessary to make only such opening in the
patient that there is room for inserting the examination and/or
treatment telescope through the opening made. It is also possible
to use one of the natural orifices in the body for introducing the
biopsy forceps, eg by endoscopy, in particular when examining the
digestive tract, optionally through the oesophagus, or when
examining the digestive tract through the rectum.
[0003] In connection with the taking of samples through such
examination and/or treatment telescope (in the following designated
"the telescope") biopsy forceps are known in the form of a
comparatively thin and long pliable object, primarily consisting of
an outer cable that extends throughout the length of the forceps,
in which outer cable an internal manoeuvring cable can be conveyed
that connects an operating handle in the outer end of the biopsy
forceps to a set of jaws at the end of the forceps that is taken
through the telescope. By influencing the operating handle the jaws
can be moved in such a manner that it is possible to bite off a
piece of tissue and pull the tissue out along with the biopsy
forceps.
[0004] For some examinations it is necessary to collect more than
one sample for subsequent analysis. To keep track of the individual
samples or series of samples taken from a specific area it is an
advantage if the samples taken can be kept in some kind of
reservoir.
[0005] Such instrument is known from U.S. Pat. No. 4,651,753. This
instrument comprises a cylindrical end with a cylindrical cutter
intended for sliding back and forth within the cylindrical end of
the instrument. An oval opening in the cylinder wall of the
cylindrical end makes it possible to suck in tissue at the
cylindrical end, following which the cylindrical cutter cuts off a
tissue sample.
[0006] This means that, when a sample is to be taken, it is
necessary to create a sub-atmospheric pressure that draws a portion
of the tissue so far into the opening in the cylinder wall that the
cylindrical cutter is able to cut off a tissue sample.
[0007] Moreover, by this instrument it is possible to take samples
only from the side of the instrument and not from the end which
means that it may be considerably more complex to manoeuvre the
instrument in position for sample collection.
[0008] Biopsy cables are also known that have jaws positioned at
the end of the cable; which jaws, however, do not perform a clean
cut; rather, they seize around the tissue and rip it off.
Novel Technique
[0009] It is the object of the invention to provide biopsy forceps
capable of accommodating the samples taken in some kind of
receptacle and capable of taking samples, where the samples are cut
or sheared off in a clean cut without having to supply vacuum or
other additional measures to introduce tissue into the sample
taking equipment.
[0010] This is accomplished by providing biopsy forceps where the
part of the forceps that performs the cut or shearing is provided
with an exchange in the form of two mutually hinged arms, wherein
the first arm comprises a holder device for securing a receptacle
part, said receptacle part being, at the end that faces away from
the arm in which the receptacle is secured, provided with a cutting
means. Another arm that, during the sample collection, cooperates
with the first arm with the receptacle is provided with some kind
of stop means or abutment that combines with the cutting means on
the receptacle to cut off or shear off the tissue sample.
[0011] The receptacle can be configured as a cylinder arranged and
secured in a corresponding opening in the first arm. The opening
for attachment of the receptacle can be closed at the bottom, but
it may also be open where an edge or collar is provided along the
edge of the opening at the end of the opening that faces away from
the other arm. In those cases where the opening is not closed at
the bottom the bottom can be replaced by some kind of sieve. The
sieve may be a plate provided with a number of holes or a kind of
grating. According to one embodiment of the opening, where the
bottom is closed, the bottom may be provided with a number of
holes.
[0012] According to another embodiment this kind of sieve may be
formed at the end of the cylindrical receptacle, which end faces
away from the end which is provided with cutting means.
[0013] The sieve serves the purpose of retaining the samples taken
with the biopsy forceps to the effect that they do not fall out at
the one end of the receptacle.
[0014] Interiorly, the receptacle may be provided with a surface
that resembles sharkskin, ie provided with a row of relatively
small one-way tips that protrude from the surface at an angle to
the effect that samples, once they have entered the receptacle by
movement along the side of the receptacle, are directed towards the
end of the receptacle that faces away from the opening.
[0015] Moreover, the stop means or abutments of the biopsy forces
can be caused to be above the opening of the receptacle when one
has finished taking samples and hence serve as lid.
[0016] This may be accomplished by the forceps being locked in a
closed position during withdrawal when no further samples are to be
taken.
[0017] The abutment may be configured essentially plane, but may be
provided with an elevation at the middle which, when the forceps
are closed, extends into the receptacle at least past the cutting
edge of the cutting means. According to a further embodiment of the
abutment, it may be provided with an indentation at the middle to
the effect that, when the forceps are closed, the receptacle, or at
least the cutting edge of the cutting means, extends into the
abutment.
[0018] When the biopsy forceps have been taken out either of the
telescope or along with the telescope, the receptacle with the
samples can be removed from the forceps. This may be accomplished
by means of tongs, optionally adapted to that particular function.
The most important aspect of such tongs for removing the receptacle
is that such tongs seize securely around the receptacle to avoid
that the samples are wasted or polluted eg if the receptacle is let
go.
[0019] The receptacle may also be provided with engagement means
that engage with cooperating means in the arm of the biopsy
forceps. For instance, a bayonet socket may be used, or a thread or
a tight-fitting connection optionally featuring a magnet for
additional attachment. The attachment of the receptacle may also be
accomplished in that the cylinder wall of the receptacle is slotted
in a longitudinal direction whereby the receptacle is squeezed and
hence secured in the arm on the tongs when positioned.
[0020] According to a further embodiment of the biopsy forceps, the
receptacle may be formed from a kind of revolver magazine, to the
effect that the magazine can be turned, following sampling, such
that a new chamber is in position for a new sample to be taken and
arranged in an empty chamber. This procedure can be repeated until
there are no more empty chambers in the magazine.
[0021] To ensure that the samples do not fall out of the charged
magazines, a disc or plate may be arranged on top of the magazine
that covers the chambers in the magazine with the exception of
precisely the chamber that has been positioned to receive the next
sample.
[0022] According to a particular embodiment the magazine may be
configured such that, at least between two chambers, there is a
distance that corresponds essentially to the diameter of a chamber.
Thereby the magazine may, following finished sampling, be parked in
a position where precisely that area is arranged corresponding to
the opening in the plate or the disc, to the effect that all of the
samples that are taken remain in their respective chambers when the
biopsy forceps are taken out of the telescope or are removed from
the patient along with the telescope.
[0023] In connection with the manoeuvring cable, an advancement
mechanism may be provided for advancing the magazine such that,
when a sample has been taken, the magazine may be advanced such
that the next chamber is in position for receiving a sample.
[0024] The advancement mechanism to the magazine is optionally
provided with a locking mechanism that either keeps the magazine in
position until the next advancement occurs or (optionally in
combination) ensures that the magazine can be advanced in only one
direction.
[0025] The advancement mechanism may be driven by the manoeuvring
cable or some other mechanism.
[0026] According to one embodiment of the advancement mechanism, it
may be configured as a relatively flat latch, leaf spring or the
like that is connected to the central manoeuvring cable in the
biopsy forceps. The advantages of the flat configuration are ia
that the latch is thereby controlled by the tool/biopsy forceps to
the effect that the latch does not capsize during activation of the
advancement of the magazine.
[0027] In other cases it is an option to use a simple rigid
material, eg the end of a cable can be used, optionally provided
with some kind of guide or slide bushing in proximity of the point
of attack, where the cable influences the magazine.
[0028] When the desired number of samples has been taken, the
samples can be taken from the magazine to a storage receptacle with
formalin or other tissue-preserving preparation, or the entire
magazine may be dismounted and arranged in formalin or other
tissue-preserving preparation, in which the tissue can be stored
until further examination takes place.
[0029] It applies to all embodiments that they may be connected to
a cable by means of a coupling where the forceps may be attached to
the outer part of the manoeuvring cable by means of snap-coupling,
bayonet socket, thread or the like, and wherein the inner cable
sliding within the outer cable is secured to an intermediate piece
for the arms of the forceps in the same manner as the one in which
a handbrake cable is secured to the brake handle of a bike or the
like.
[0030] Thereby various tools can be used in conjunction with a
cable, and by a bore being configured at that end of the telescope
which is inside the patient in use, which bore is larger than the
passage in which the cable usually travels, it is possible to mount
the tool on the cable after the cable has been taken through the
passage within the telescope.
[0031] However, the invention is not restricted to that embodiment,
some tools allowing, due to their size, them to travel through the
passage in the telescope along with the cable after the telescope
has been deployed in the patient.
[0032] By the invention according to claim 1 it is accomplished
that the tissue sample taken is not torn off, but rather cut or
sheared off with a clean cut.
[0033] By claim 2 it is accomplished that samples taken can be sent
to examination stored in and protected by the receptacle, the
latter being dismountable.
[0034] By claims 3 and 4 it is accomplished that samples taken can
be sent to examination, where each sample can be associated with a
specific chamber for identification or determination of when the
sample was taken.
[0035] By the invention as described in claim 5 it is accomplished
that the sample does not fall out of the receptacle or the chamber
in which it is stored.
[0036] By claim 6 it is accomplished that the tool can be coupled
to the cable after the cable has been taken through a smaller
passage within the telescope, and that optional tools are available
for use in connection with the same cable.
[0037] By claims 7 and 8 according to the invention, it is
accomplished that liquid and the like may travel through holes or
net, while the collected samples are unable to pass and hence
remain in the receptacle or chamber.
[0038] By claims 9 and 10 a convenient manner is accomplished in
which an empty chamber can be positioned for collecting a
sample.
[0039] It is also possible to apply the technique to a capsule
endoscopy where the patient is intended to swallow a capsule, which
capsule passes through the intestines of the patient. During the
passage, it is possible to take pictures, video and to perform
scans of internal organs and the like.
[0040] By configuring such capsule with the tool described in the
invention, where the tool is activated by manoeuvring means
from/inside the capsule, further options are provided for
performing samplings from the intestines of a patient in a
convenient manner. The capsule may optionally be manoeuvred or
directed through the patient by means of magnetic fields, remote
control or the like wireless transfer. It is also conceivable that
transfer of control signals is accomplished through a cable that is
carefully pulled out of the patient again, along with the capsule,
or, following ended use, the cable may be disconnected from the
capsule and be carefully pulled out of the patient, after which the
capsule continues out of the patient by the natural route.
[0041] In the following, the invention will be described in further
detail with reference to the drawing, wherein:
[0042] FIG. 1 shows biopsy forceps with exchange and replaceable
receptacle, wherein the arm holding the receptacle is shown in
partially sectional view;
[0043] FIG. 2 shows the forceps of FIG. 1 in closed position;
[0044] FIG. 3 shows the forceps just before a sample is taken;
[0045] FIG. 4 shows the forceps during sampling;
[0046] FIG. 5 shows the forceps when the sample has been taken and
the receptacle has been released from the forceps;
[0047] FIG. 6 shows an embodiment of the biopsy forceps with a
turnable drum or cylinder with several chambers;
[0048] FIG. 7 shows the forceps of FIG. 6 just before a sample is
taken;
[0049] FIG. 8 shows the forceps of FIG. 7 during sampling;
[0050] FIG. 9 shows a drum or cylinder with several chambers for
the forceps;
[0051] FIG. 10 schematically shows the advancement mechanism for
advancing an empty chamber; and
[0052] FIG. 11 shows the forceps shown in FIG. 7, seen from above,
with the advancement mechanism.
[0053] Now convenient embodiments of the invention will be
described. Biopsy forceps 1, used primarily for taking tissue
samples and the like in the context of use of a kind of examination
or treatment telescope (not shown) in the treatment of humans or
animal's, comprise a kind of manoeuvring unit 2 in the form of a
cable or the like, which cable 2 comprises at least an inner
portion 18 and at least an outer portion that can be moved relative
to each other to the effect that some kind of tool 3 arranged at
the end of the cable 2 which is, via the telescope, conveyed into a
patient can be operated by influencing one or more operating
handles arranged at that end of the cable 2 that is arranged at the
operating end of the telescope. A telescope for exercising such
samplings usually comprises a number of passages in addition to a
passage for the operating cable 2 or the sampling cable which, in
combination with the tool 3, constitutes a biopsy cable or biopsy
forceps 1. For instance, those passages are intended for sucking or
flushing liquid and the like. At the end of the telescope, more
specifically the end which is intended for being conveyed into the
patient, a camera is arranged, whereby it is possible to see how
the telescope is to be moved during insertion, and how the biopsy
forceps 1 are to be moved to take the intended sample in the right
place.
[0054] At the end of the cable 2 where the sample is to be taken,
either a tool for sampling 3 is arranged, or coupling means 4 are
provided for connecting and disconnecting a tool, which coupling
means may be of ordinary type. The most important aspect in this
context is that a tool 3 can be arranged at the end of the cable 2
in such a manner that it is easy to replace if, in some scenario or
other, there is a need for securing another type of tool 3 to the
cable 2 and for the tool 3 to be secured onto the cable 2 in a
reliable manner without a risk of it falling off during use.
[0055] The biopsy forceps 1 are, in the part of the forceps that
that performs cutting or shearing, provided with an exchange in the
form of two mutually hinged arms 5, 9, where the first arm 5
comprises a holder device 6 for attaching a receptacle part 7 which
receptacle part 7 is, at the end that faces away from the arm 5 in
which the receptacle 7 is secured, provided with a cutting means 8.
Another arm 9 which, during the sampling, cooperates with the first
arm 5 with the receptacle 7, is provided with some kind of stop
means or abutment 10 that combines with the cutting means 8 on the
receptacle 7 to cut off or shear off the tissue sample 11.
[0056] The receptacle 7 may be configured as a cylinder that is
arranged and secured in a corresponding opening 6 in the first arm
5. The opening 6 for attachment of the receptacle 7 may be closed
at the bottom, but it may also be open where there is an edge or
collar along the edge of the opening 6 at that end of the opening
that faces away from the other arm 9. In those cases where the
opening 6 is not closed at the bottom, the bottom may be replaced
by some kind of sieve. This sieve may be a plate that is provided
with a number of holes or in the shape of a grating. According to
one embodiment of the opening, where the bottom is closed, the
bottom may be provided with a number of holes.
[0057] According to another embodiment, that kind of sieve may be
configured at the end of the cylindrical receptacle 7, which is the
end that faces away from the end which is provided with cutting
means 8.
[0058] The sieve serves the purpose of withholding the samples 11
that are taken with the biopsy forceps 1 to the effect that they do
not fall out of the one end of the receptacle 7.
[0059] Interiorly, the receptacle may be provided with a surface
that resembles sharkskin, that is with a number of relatively small
one-way tips that protrude from the surface at an angle to the
effect that samples, once they have entered the receptacle by
movement along the sides of the receptacle, are directed towards
the end of the receptacle 7 that faces away from the receptacle
opening.
[0060] Moreover the stop means or abutment 10 of the biopsy forceps
1 may be arranged above the opening of the receptacle 7, once one
has finished taking samples, and hence it will serve as lid.
[0061] This can be accomplished in that, when no more samples are
to be taken, the forceps 1 can be locked in closed position during
withdrawal.
[0062] The abutment 10 can be configured to be essentially plane,
but it may be provided with an elevation at the middle which, when
the forceps 1 are closed, extends into the receptacle at least past
the cutting edge of the cutting means 8. According to another
embodiment of the abutment 10, it may be configured with an
indentation at the centre to the effect that, when the forceps 1
are closed, the receptacle 7, or at least the cutting edge of the
cutting means 8, extends into to the abutment 10.
[0063] When the biopsy forceps 1 has been removed either from the
telescope or along with the telescope, the receptacle 7 with the
samples 11 can be removed from the forceps 1. This can be
accomplished by means of tongs, optionally adapted for this
particular function. The most important aspect of such tongs for
removing the receptacle 7 is that the tongs have a secure grip
around the receptacle 7 to avoid that the samples 11 are wasted or
polluted, eg if the receptacle 7 is let go.
[0064] The receptacle 7 may also be provided with engagement means
that engage with cooperating means in the arm 5 of the biopsy
forceps 1. For instance, a bayonet socket, a thread or a tightly
fitting connection optionally with a magnet for additional
attachment may be used. The attachment of the receptacle 7 may also
be accomplished by the cylindrical wall of the receptacle being
slotted in a longitudinal direction, whereby the receptacle 7 is,
when arranged, squeezed together and hence secured in the arm 5 on
the forceps 1.
[0065] According to another embodiment of the biopsy forceps 1, the
receptacle may be formed from some kind of drum or cylinder 12 that
constitutes a magazine to the effect that the magazine 12 can be
turned following a sample 11 has been taken such that a new chamber
13 is caused to be in position for another sample 11 to be taken
and arranged in an empty chamber 13. This procedure can be repeated
until there are no more empty chambers 13 in the magazine 12.
[0066] Here the sampling takes place in the same manner in that the
arm 9 with some kind of abutment 10 presses the sample 11 against a
cutting means, whereby the sample is cut off and arranged in a
chamber 13.
[0067] The drum 12 may rotate about a shaft 14 that secures the
drum 12 to the first arm 5. A latch, leaf spring 15 or the like is
coupled to the inner cable 18 and advances or turns the drum 12 one
storage space or one chamber 13 each time the forceps 1 are opened
completely. The drum 12 may furthermore be provided with a
spring-biased lock that ensures that the drum 12 does not turn
unintentionally.
[0068] The advantage of a flat configuration is that the latch 15
is thereby controlled by the tool/biopsy forceps 1 to the effect
that the latch 15 does not capsize when the advancement of the
magazine 12 is activated.
[0069] In other cases, a simple rigid material may be used, for
instance the end of a cable 2 can be used optionally provided with
some kind of guide or slide bushing in proximity of the point of
attack, where the cable 2 influences the magazine 12.
[0070] To ensure that the samples 11 do not fall out of the charged
chambers 13 there may be arranged a disc or plate 16 above the
magazine 12 that covers the chambers 13 in the magazine 12 with the
exception of precisely the chamber 13 that has been positioned to
receive the next sample 11. When the last sample 11 has been taken,
the forceps 1 are kept closed during withdrawal of the endoscope.
The upper cover plate or disc 16 may, by means of a sharp edge at
its opening, form a cutting means for the sampling. The upper cover
plate 16 is secured on the shaft 14 relative to the first arm 5
such that the cover plate 16 does not turn relative to the arm.
[0071] A lower cover plate 17 is arranged between drum 12 and the
first arm 5. This cover plate 17 may either rotate along with the
drum 12 or be fixed relative to the first arm 5.
[0072] According to a particular embodiment the magazine 12 may be
configured such that, at least between two chambers 13, there is a
distance that essentially corresponds to the diameter of a chamber
13. Thereby the magazine 12 may, following ended sampling, be
parked in a position where precisely that area is arranged just
opposite the opening in the upper plate or disc 16 to the effect
that all of the samples 11 that are taken remain in their
respective chambers 13 when the biopsy forceps 1 are taken out of
the telescope or removed from the patient along with the
telescope.
[0073] The advancement mechanism 15 for the magazine 12 may be
provided with a locking mechanism ensuring that the magazine 12 can
be advanced in only one direction.
[0074] The advancement mechanism can be driven by the inner cable
18 or by some other mechanism.
[0075] When the desired number of samples have been taken, the
samples 11 may be advanced from the magazine 12 into a storage
receptacle with formalin or other tissue-preserving preparation, or
the entire magazine 12 may be dismounted and arranged in formalin
or other tissue-preserving preparation in which the samples 11 may
be stored until further examination takes place.
[0076] It applies to all embodiments that they may be connected to
a cable by means of a coupling 4, where the forceps are secured to
the outer part of the manoeuvring cable 2 by means of a snap
coupling, bayonet socket, thread or the like, and wherein the inner
cable 18 that slides within the outer cable, is secured to an
intermediate piece 19 to the arms of the forceps in the same manner
as the way in which a handbrake cable is secured to the brake
handle of a bike or the like.
[0077] Thereby various tools may be used in connection with a
cable, and in that a bore is provided at the end of the telescope
that is, during use, located inside the patient, which bore is
larger than the passage in which the cable usually travels, it is
possible to mount the tool on the cable after the cable has been
taken through the passage in the telescope.
[0078] However, the invention is not limited to that embodiment,
some tools allowing, due to their size, that they can be conveyed
through the passage in the telescope along with the cable after the
telescope has been arranged inside the patient.
[0079] By providing a bore or the like measure to increase the
diameter of the passages within the telescope at that end of the
telescope which is intended for being introduced into the patient,
a kind of "garage" is provided in which the tool 3 can be stored
during introduction and withdrawal of the telescope into and from
the patient in those cases where the coupling 4 on the cable is
used for securing a tool 3 which is too large for travelling
through the passage in the telescope.
[0080] The bore in the telescope is used to advantage in that the
tool 3 is mounted on the cable 2 after the cable 2 has been taken
through the cable passage. Then the cable 2 is pulled so far back
that the tool 3 is completely or partially enclosed by the
bore.
[0081] Obviously, the invention can be combined crosswise of the
various embodiments of the invention described above.
[0082] In the context of the various embodiments of the tool 3, it
is an option, at that end of the tool 3 that faces towards the
coupling means of the cable, to provide connection for suction
and/or flushing passages either via passages in the telescope or
via connection at the manoeuvring end of the telescope or the
biopsy cable.
[0083] The individual tools that can thus be arranged at the end of
a biopsy cable may have different dimensions adapted in accordance
with the task for which the tool is used.
* * * * *